JP2019529060A5

JP2019529060A5 -

Info

Publication number: JP2019529060A5
Application number: JP2019540292A
Authority: JP
Filing date: 2017-10-06
Publication date: 2020-11-12
Anticipated expiration: 2037-10-06

Claims

A preoperative planning method for a computer-implemented interactive patient-specific surgical planning system.
Steps to implement a preoperative plan for partial or total joint replacement,
Steps to determine the best fit size for one of multiple joint implants,
A step of performing a range of motion analysis, including virtually positioning each of the plurality of joint implants under assessment in a patient-specific kinematic model of the joint.
A step of performing a soft tissue analysis using the patient-specific kinematic model of the virtually positioned joint implant, and
Steps to evaluate and adjust the characteristics of each of the plurality of joint implants within the patient-specific kinematic model to prioritize higher range of motion for patient-designated postoperative exercise for selected activities in daily life. When,
A step of selecting a patient-specific surgical guide to be used with the joint implant selected based on a preoperative planning analysis of the steps to be performed, and
Preoperative planning methods for computer-implemented interactive patient-specific surgical planning systems, including.

The step of implementing the preoperative plan is
Analyzing joint lines,
Comparing the original joint line with a new joint line that is substantially similar to the original joint line,
To measure the repositioning distance of the humerus nodule compared to the scapula, compare three-dimensional vectors representing the distance and direction between tendon and muscle insertions in the humerus, including the scapula and humerus. thing,
Determining the diameter of the humeral head,
Determining the height of the humeral head,
Sizing the humerus implant from digital images,
The method of claim 1, comprising at least one of the above.

The steps of performing the range of motion analysis include simulating the movement of a virtually implanted joint through the extreme range of motion, measuring the collision position, and compensating for the required functional range of motion. The method according to claim 1 or 2.

The step of performing the soft tissue analysis further determines the major soft tissue insertion point, measures the three-dimensional distance for comparison with the preoperative state, evaluates the length in the extreme range of motion, and changes the length of the soft tissue. Alternatively, the method of any one of claims 1 to 3, comprising ensuring that the reduction is substantially maintained within the anatomical range to substantially obtain the most common activity of daily life. ..

The step of evaluating and adjusting the characteristics of each of the plurality of joint implants
Evaluating and adjusting the thickness / height of the glenoid implant,
Evaluating and adjusting the depth of the glenoid,
Evaluating and adjusting the thickness of the graft,
The method according to any one of claims 1 to 4, wherein the method comprises.

The method of any one of claims 1-5, further comprising instructions in a comprehensive preoperative total joint planning method for comparison of anatomical or reverse shoulder surgery implants or guides.

Analysis of a range of motion, including the step of performing the range of motion analysis, imagining the implant through the extreme range of motion, measuring the collision position and compensating for the required functional range of motion. The method according to any one of claims 1 to 6, further comprising carrying out.

Steps to build alignment between the patient's bone and the statistical shape model of the bone of interest,
The step of extracting the principle mode representing the patient's bone and
Steps to define a fixed configuration, position, or dimension according to the corresponding principle mode,
The step of applying collision detection to confirm the bone fixation configuration and
According to claim 1, further comprising optimizing the dimensions of the fixation element of the glenoid implant using the corresponding matrix between the patient's three-dimensional (3D) bone structure and the statistical shape-based atlas. The method according to any one of 7 to 7.

The partial or total joint surgery replacement includes shoulder surgery.
Whether the glenoid coverage was maximized, the protrusion of the glenoid surface was minimized, the bone removed on the glenoid surface was minimized, the backward tilt of the glenoid was about. Whether it is less than 5 to about 10 degrees, whether the glenoid implant is seated greater than about 80% of the implant coverage area, whether the anterior penetration of the glenoid cortical wall is minimized, said. Whether there is bone thickness greater than about 3 mm behind the glenoid, whether the orientation offset between the natural glenoid and the above / inferior axis of the implant is less than about 5 degrees, with upward or downward tilt Whether the natural glenoid is less than 5 degrees, the lack of protrusion of the humerus compared to the cut or prepared surface of the humerus, the difference in humerus diameter between the anatomical structure and the implant Whether it is less than about 3 mm, whether the difference in humeral head height between the anatomical structure and the implant is less than about 1 mm, about 2 mm relative to the midline head margin compared to the anatomical structure Determining if less than greater cohesion is present, thereby identifying treatment risk, and the choice of prosthesis implant in the selected shoulder glenoid surgery is partially based on the identified treatment risk. The method of any of claims 25-40, further comprising the step of identifying and comparing the treatment risk with the reverse type or anatomical glenoid treatment selected by.

Glenoid implants are augmented to fit patients who have undergone preoperative planning for anatomical or reverse shoulder joint procedures.
Claim 5 or 9, wherein the depth of the augmentation, the size of the augmentation, and / or the radial position of the augmentation varies depending on the preoperative plan of the anatomical or reverse shoulder joint procedure selected. The method according to any one of the above.

The partial or total joint surgery replacement includes shoulder surgery.
Steps to obtain a patient-specific shoulder surgery guide based on selected anatomical or reverse surgical procedures, and
Claims 1-10, further comprising a shoulder joint surgery guide or a step that results in a selected anatomical or reverse shoulder joint procedure, wherein the step that results in the shoulder joint surgery guide comprises using a 3D printing device. The method according to any one item.

The partial or total joint surgery replacement includes shoulder surgery.
For the selected anatomical or reverse surgical procedure, glenoid implant size, augmentation depth, augmentation position, positioning in 6 degrees of freedom, fixation type, fixation size, reaming depth, reaming diameter, reaming angle , And / or the method of any one of claims 1-11, further comprising a step of recommending a prosthetic shoulder implant and placement position selected from the group consisting of adjustments in combinations thereof.

The step of performing the soft tissue analysis is to run the patient-adapted engine to adapt the joint-specific kinematic model to include one or more patient-specific conditions. Including modifying at least one of the bones, soft tissues or landmarks in to render a patient-specific kinematic model.
The step of evaluating and adjusting the characteristics of each of the plurality of joint implants is selected in the patient-specific kinematic model by operating a prosthesis test engine and performing full or partial joint surgery electronically. Including simulating the joint movements of said patients with selected implants while positioning the implants and performing daily activities, and further
The method of any one of claims 1-12, comprising the step of selecting an actual implant for a planned surgical procedure performed on the patient.
including.

A computer-readable medium containing an executable instruction that controls execution of the method according to any one of claims 1 to 13 when executed by a computer processor.